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糖尿病患者教育:一项荟萃分析与元回归分析

Diabetes patient education: a meta-analysis and meta-regression.

作者信息

Ellis Shelley E, Speroff Theodore, Dittus Robert S, Brown Anne, Pichert James W, Elasy Tom A

机构信息

Department of Medicine, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA.

出版信息

Patient Educ Couns. 2004 Jan;52(1):97-105. doi: 10.1016/s0738-3991(03)00016-8.

Abstract

Diabetes education has largely been accepted in diabetes care. The effect of diabetes education on glycemic control and the components of education responsible for such an effect are uncertain. We performed a meta-analysis of randomized controlled trials of diabetes patient education published between 1990 and December 2000 to quantitatively assess and characterize the effect of patient education on glycated hemoglobin (HbA(1c)). Additionally, we used meta-regression to analyze which variables within an education intervention that best explained variance in glycemic control. Twenty-eight educational interventions (n=2439) were included in the analysis. The net glycemic change was 0.320% lower in the intervention group than in the control group. Meta-regression revealed that interventions which included a face-to-face delivery, cognitive reframing teaching method, and exercise content were more likely to improve glycemic control. Those three areas collectively explained 44% of the variance in glycemic control. Current patient education interventions modestly improve glycemic control in adults with diabetes. We highlight three potential components of educational interventions that may predict an increased likelihood of success in ameliorating glycemic control.

摘要

糖尿病教育在糖尿病护理中已基本得到认可。糖尿病教育对血糖控制的效果以及造成这种效果的教育组成部分尚不确定。我们对1990年至2000年12月期间发表的糖尿病患者教育随机对照试验进行了荟萃分析,以定量评估和描述患者教育对糖化血红蛋白(HbA(1c))的影响。此外,我们使用荟萃回归分析教育干预中的哪些变量最能解释血糖控制的差异。分析纳入了28项教育干预措施(n = 2439)。干预组的净血糖变化比对照组低0.320%。荟萃回归显示,包括面对面授课、认知重构教学方法和运动内容的干预措施更有可能改善血糖控制。这三个方面共同解释了血糖控制差异的44%。目前的患者教育干预措施适度改善了成年糖尿病患者的血糖控制。我们强调了教育干预的三个潜在组成部分,它们可能预示着改善血糖控制成功可能性的增加。

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